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- 저자 : 朴海壽 (검색결과 119 건)
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朴海壽,姜東淑 中央醫學社 1964 中央醫學 Vol.7 No.3
Airway obstruction is one of the few real emergencies in medical practice. The history of tracheotomy is long and still it remains as one of the most important life saving procedure in case of asphyxia. This article report the result of clinical studies on 92 cases of tracheotomy performed at the E. N. T. Clinic, Inchon Methodist hospital, Inchon, Korea, covering-a three years period from January, 1960 to December, 1962. Among 719 E. N. T. operations, tracheotomy cases were 92 (12.6 per cent). This was surprisingly high number in frequency, 58 (63 per cent) of these cases were male and 34 (37 per cent) were female. Approximately two third of the cases were between one and five years of age (58.6 per cent), and youngest was 13 months and oldest was 58 year-old. Majority of the cases occurred in winter time while none case occurred in August and September. Analysis of the causative disease revealed more than two third of the cases were laryngeal or pharyngeal diphtheria, and none diphtheric acute laryngitis, laryngeal abscess, laryngeal edema, retropharyngeal abscess, intoxication, foreign body, Ludwig's angina, laryngeal cancer, laryngeal papilloma were next in order. Decannulation could be performed within one week in the most of diphtheria cases. The complication rate was 16.3 per cent (15 cases), and following postoperative complications were seen: cervical subcutaneous emphysema in four cases, mediastinal emphysema in one case, pneumothorax in one case, postoperative hemorrhage in two cases, pulmonary. atelectasis in three cases, and possible pneumonia in one case. As a permanent complication hoarseness developed in one case, caused by protracted perichondritis, which occurred following severe laryngeal abscess. The mortality rate was 8.6 per cent: 8 cases were died during or after operation. Three caes who died during operation visited the hospital with almost exhausted state because of imminent asphyxia. Among five cases, who died after operation, one death occurred due to extensive mediastinal emphysema with pneumothorax, one due to reobstruction of the airway, two due to cardiac failure(diphtheria cases), and one due to unknown cause. Following warnings summarized: 1) Tracheotomy should never be underestimated as a simple and easy surgical procedure, this is especially true in children and emrgency situation, 2) Unless temporary adequate airway is being provided general anesthesia. must be avoided even routine premedication such as administration of sedatives or narcotics. 3) Policy of watch and wait until last minutes should be condemned: tracheotomy should be done as elective rather than emergency. 4) In case of impending asphyxia emergency establishment of airway, such as introduction of bronchoscope, Mosher's life saving tube, or endotracheal tube, is considered to be very wise way to perform uneventful tracheotomy, it is, however, almost impossible to do so in some occasions. In such instances emergency tracheotomy is mandatory. 5) Surgeon should familiar with both orderly tracheotomy and emergency tracheotomy technic. 6) As Jackson recommended authors emphasize that tracheotomy should be done as low as possible, this is particularly so in younger age group to pervent decannulation difficulty. 7) Aftercare cf tracheotomized case is not easy. Doctor and nurses should always keep in mind that reobstruction of the airway can be happened by various causes, Regulation of the room temperature and humidity seems to be very important in keeping airway free from crust formation.
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박해수,손웅희,윤용산,Park, Hae-Soo,Shon, Woong-Hee,Yoon, Yong-San 대한의용생체공학회 1989 의공학회지 Vol.10 No.3
The initial impact at foot strike is produced by a slider type mechanical model, which can be measured using a force platform to evaluate various shoes. The lower extremity and foot motion was filmed by a 16mm high speed movie camera and several points on the rear half of the shoe and those near the trochanter and the lateral epicondyle were digitized to provide the linear and angular positions and velocities during impact. With these observed kinematics, a slider type foot strike simulator composed of guide rail and sliding dummy is designed. The simulator system makes the artificial foot of the dummy with running shoe on it to follow the foot strike motion. The dummy has the relevant mass-spring-damper system modeled after McMahon's. The motion of the model is drived by the gravity force and the generated motion alone with the ground reaction forces are monitored by the same procedures afore mentioned producing the initial foot strike impact similar to the onto observed in human gait.
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박해수,박양병 대한산업공학회 2009 대한산업공학회 추계학술대회논문집 Vol.2009 No.10
자동판매기 시스템을 운영하는데 있어 제품별 보관함 수와 보충주기의 결정은 자동판매기의 총수익에 영향을 미치는 중요한 의사결정문제이다. 왜냐하면, 이들은 자동판매기에서 품절과 재고유지비, 그리고 수송비에 직접인 영향을 미치기 때문이다. 본 논문에서는 자동판매기 고객의 재고부족 시 수요대체와 포기 현상이 존재하는 상황에서 계획기간 동안의 총수익을 최대화하는 자동판매기의 제품별 보관함 수와 보충주기를 동시에 결정하는 수리모형을 구축하고, 이를 토대로 휴리스틱 해법을 제안한다. 그리고 간단한 예제에 대한 시뮬레이션을 통하여 해법의 성능을 평가한다.
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